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The worldwide population is ageing, alongside an increase in cancer incidence rates. Over the past 10 years, there has been huge progress in the field of oncology with earlier diagnosis and an expansion of treatment options, leading to a growing number of older people living with cancer. That has meant that caring for older patients with cancer is now part of day-to-day oncology practices. This cohort often has geriatric syndromes and a higher prevalence of frailty and complex needs and preparing our clinical services to optimise care for these patients is essential. Whilst it is widely accepted that comprehensive geriatric assessments are of benefit to patients, only a small proportion of patients can access these through specialised teams during their cancer care. In the past few years there has been significant progress in this field throughout the United Kingdom (UK). The goal of this review is to inform other health care systems how to learn from what has been done in the UK. This paper provides an update from our previous review in 2020, detailing the new services being implemented and made available to patients and an expansion in the number of new pilot teams and research projects/trials throughout the four nations of the UK., Competing Interests: Declaration of Competing Interest Mark Baxter reports a relationship with Servier Monde that includes: consulting or advisory, speaking and lecture fees, and travel reimbursement. Mark Baxter reports a relationship with Ipsen that includes: speaking and lecture fees and travel reimbursement. Mark Baxter reports a relationship with Bristol Myers Squibb Co that includes: speaking and lecture fees. Mark Baxter reports a relationship with Merck Sharp & Dohme UK Ltd. that includes: speaking and lecture fees. Kirsty Balachandran reports a relationship with Bristol Myers Squibb Co that includes: speaking and lecture fees. Anne Barrell reports a relationship with Roche that includes: travel reimbursement. Anne Barrell reports a relationship with Bristol Myers Squibb Co that includes: speaking and lecture fees. Anne Barrell reports a relationship with Novartis AG that includes: speaking and lecture fees. Nicolo Matteo Luca Battisti reports a relationship with Pfizer Inc. that includes: board membership, speaking and lecture fees, and travel reimbursement. Nicolo Matteo Luca Battisti reports a relationship with Abbott that includes: board membership. Nicolo Matteo Luca Battisti reports a relationship with Sanofi that includes: board membership and speaking and lecture fees. Nicolo Matteo Luca Battisti reports a relationship with Astellas Pharma Inc. that includes: board membership. Nicolo Matteo Luca Battisti reports a relationship with Exact Sciences Corporation that includes: travel reimbursement. Nicolo Matteo Luca Battisti reports a relationship with Eli Lilly and Company that includes: speaking and lecture fees and travel reimbursement. Nicolo Matteo Luca Battisti reports a relationship with AbbVie Inc. that includes: speaking and lecture fees. Nicolo Matteo Luca Battisti reports a relationship with Roche that includes: speaking and lecture fees. Nicolo Matteo Luca Battisti reports a relationship with Servier Monde that includes: speaking and lecture fees. Nicolo Matteo Luca Battisti reports a relationship with Gilead Sciences Inc. that includes: speaking and lecture fees. Nicolo Matteo Luca Battisti reports a relationship with AstraZeneca Pharmaceuticals LP that includes: speaking and lecture fees. Kwok-Leung Cheung reports a relationship with Roche that includes: consulting or advisory. Kwok-Leung Cheung reports a relationship with Cancers that includes: travel reimbursement. Helen Brown reports a relationship with Roche that includes: funding grants. Fabio Gomes reports a relationship with AstraZeneca Pharmaceuticals LP that includes: speaking and lecture fees and travel reimbursement. Fabio Gomes reports a relationship with Roche that includes: speaking and lecture fees and travel reimbursement. Fabio Gomes reports a relationship with Boehringer Ingelheim GmbH that includes: speaking and lecture fees and travel reimbursement. Fabio Gomes reports a relationship with Pfizer Inc. that includes: speaking and lecture fees and travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Type 2 biologics have been used increasingly for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP). However, patterns of biologic switching are understudied, and established guidelines for sequential or simultaneous use do not yet exist., Methods: This is a Canadian multicenter retrospective study of real-world patient data. Patients were included if they had recurrent CRSwNP despite maximal medical and surgical management, and received at least one dose of a type 2 biologic. Patients who remained on their initial biologic comprised the continuous group. Patients with sequential or simultaneous use of more than one biologic comprised the switched group. We compared the characteristics of patients who continued and switched biologics., Results: Note that 225 consecutive patients were included. Thirty-six (16%) switched biologics at least once, and six (3%) switched twice. The most common switch was from mepolizumab to dupilumab, with poor control of CRSwNP symptoms being the leading cause for this switch. Lack of efficacy was the main reason for switching off mepolizumab and omalizumab, while adverse events were the leading cause for switching off dupilumab. Additionally, mepolizumab patients were more likely to switch biologics late in their treatment, while dupilumab patients rarely switched after 12 months of therapy (p-value < 0.001)., Conclusions: Switching biologics for CRSwNP is frequent in Canadian rhinology practices, with 16% of patients switching at least once. The most common switch is from mepolizumab to dupilumab with inadequate CRSwNP control driving this switch. This study may help guide sequential or simultaneous use of biologics in CRSwNP patients., (© 2024 The Author(s). International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society.)

Objective: To verify the feasibility and discuss advantages and disadvantages of a piezoelectric orbitotomy during superior eyelid endoscopic transorbital approach (SETOA). An illustrative case demonstrating the application of this novel technique is also presented., Methods: Exoscopic/endoscopic SETOA to middle cranial fossa was performed on 5 adult specimens. The surgical corridor was created via piezoelectric orbitotomy by performing 3 selective and safe micrometric bone cuts providing a 1-piece trapezoid bone flap, which was repositioned and secured at the end of the procedure. A three-dimensional scan of the bone flap allowed us to reconstruct a three-dimensional model and calculate its volume., Results: Anatomical-morphometric quantitative analysis showed a mean bone volume gain of 1574.26 mm 3 by using piezoelectric orbitotomy. Piezoelectric orbitotomy also yielded concrete surgical advantages and theoretical benefits in terms of functional and esthetic outcomes. All osteotomies were micrometric clear-cut and precise, resulting in a very thin bone gap; complete sparing of soft tissues and neurovascular structures in and around the orbit was observed. Lateral orbital wall reconstruction by replacing the bone flap was performed to mitigate the risk of enophthalmos, proptosis, cerebrospinal leakage, pseudomeningocele, and pulsatile headache, which represent significant challenges., Conclusions: Piezoelectric orbitotomy may offer a viable, selective, effective, safe alternative to high-speed drilling during SETOA, especially for patients with intra-axial pathologies, in which a watertight closure is mandatory. This procedure could prevent or decrease the risk of some of the main postoperative complications associated with standard SETOA, potentially resulting in better functional and esthetic outcomes., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

In this paper, a comprehensive study of the mechanical properties of selective laser sintered polyamide components is presented, for various different process parameters as well as environmental testing conditions. For the optimization of the static and dynamic mechanical load behavior, different process parameters, e.g., laser power, scan speed, and build temperature, were varied, defining an optimal parameter combination. First, the influence of the different process parameters was tested, leading to a constant energy density for different combinations. Due to similarities in mechanical load behavior, the energy density was identified as a decisive factor, mostly independent of the input parameters. Thus, secondly, the energy density was varied by the different parameters, exhibiting large differences for all levels of fatigue behavior. An optimal parameter combination of 18 W for the laser power and a scan speed of 2666 mm/s was determined, as a higher energy density led to the best results in static and dynamic testing. According to this, the variation in build temperature was investigated, leading to improvements in tensile strength and fatigue strength at higher build temperatures. Furthermore, different ambient temperatures during testing were evaluated, as the temperature-dependent behavior of polymers is of high importance for industrial applications. An increased ambient temperature as well as active cooling during testing was examined, having a significant impact on the high cycle fatigue regime and on the endurance limit.

Background: Nursing faces increasing pressure due to changing demographics and a shortage of skilled workers. Artificial intelligence (AI) offers an opportunity to relieve nurses and reduce pressure. The perception of AI by nurses is crucial for successful implementation. Due to a limited research state, our study aims to investigate nurses' knowledge and perceptions of AI., Methods: In June 2023, we conducted a cross-sectional online survey of nurses in Bavaria, Germany. A convenience sample via care facilities was used for the questionnaire oriented on existing AI surveys. Data analysis was performed descriptively, and we used a template analysis to evaluate free-text answers., Results: 114 (♀67.5 %, ♂32.5 %) nurses participated. Results show that knowledge about AI is limited, as only 25.2 % can be described as AI experts. German nurses strongly associate AI with (i) computers and hardware, (ii) programming-based software, (iii) a database tool, (iv) learning, and (v) making decisions. Two-thirds of nurses report AI as an opportunity. Concerns arise as AI is seen as uncontrollable or threat. Administration staff are seen as the biggest profiteers., Conclusion: Even though there is a lack of clear understanding of AI technology among nurses, the majority recognizes the benefits that AI can bring in terms of relief or support. We suggest that nurses should be better prepared for AI in the future, e.g., through training and continuing education measures. Nurses are the working group that uses AI and are crucial for implementing nursing AI., (© 2024. The Author(s).)

Transportation tasks in nursing are common, often overlooked, and directly impact patient care time in the context of staff shortages and an aging society. Current studies lack a specific focus on transportation tasks, a gap our research aims to fill. By providing detailed data on transportation needs in nursing, our study establishes a crucial foundation for the development and integration of assistive robots in clinical settings. In July and September 2023, we conducted weekly observations of nurses to assess clinical transportation needs. We aim to understand the economic impact and the methods nurses use for transportation tasks. We conducted a participant observation using a standardized app-based form over a seven-day observation period in two rural clinics. N = 1830 transports were made by nurses and examined by descriptive analysis. Non-medical supplies account for 27.05% (n = 495) of all transports, followed by medical supplies at 17.32% (n = 317), pharmacotherapy at 14.10% (n = 258) and other other categories like meals or drinks contributing 12.68% (n = 232). Most transports had a factual transport time of under a minute, with patient transport and lab samples displaying more variability. In total, 77.15% of all transports were made by hand. Requirements to collect items or connect transports with patient care were included in 5% of all transports. Our economic evaluation highlighted meals as the most costly transport, with 9596.16 € per year in the observed clinics. Budget-friendly robots would amortize these costs over one year by transporting meals. We support understanding nurses' transportation needs via further research on assistive robots to validate our findings and determine the feasibility of transport robots.

Our cross-sectional study, conducted from October 2022 to January 2023, aims to assess post-COVID job satisfaction, crucial work dimensions, and self-reported factors influencing nursing retention. Using an online survey, we surveyed 2572 nurses in different working fields in Bavaria, Germany. We employed a quantitative analysis, including a multivariable regression, to assess key influence factors on nursing retention. In addition, we evaluated open-ended questions via a template analysis to use in a joint display. In the status quo, 43.2% of nurses were not committed to staying in the profession over the next 12 months. A total of 66.7% of our surveyed nurses were found to be dissatisfied with the (i) time for direct patient care. Sources of dissatisfaction above 50% include (ii) service organization, (iii) documentation, (iv) codetermination, and (v) payment. The qualitative data underline necessary improvements in these areas. Regarding retention factors, we identified that nurses with (i) older age, (ii) living alone, (iii) not working in elder care, (iv) satisfactory working hours, (v) satisfactory career choice, (vi) career opportunities, (vii) satisfactory payment, and (viii) adequate working and rest times are more likely to remain in the profession. Conversely, dissatisfaction in (ix) supporting people makes nurses more likely to leave their profession and show emotional constraints. We uncovered a dichotomy where nurses have strong empathy for their profession but yearn for improvements due to unmet expectations. Policy implications should include measures for younger nurses and those in elderly care. Nevertheless, there is a need for further research, because our research is limited by potential bias from convenience sampling, and digitalization will soon show up as a potential solution to improve, e.g., documentation and enhanced time for direct patient time.

Avian vaccines are a key factor when it comes to ensuring the availability of products derived from healthy poultry and preventing the transmission of infections from domestic and wildlife birds to humans. A marketing authorization for veterinary vaccines is granted after the product's quality, safety, and efficacy have been confirmed. During the licensing procedure, the manufacturing process is assessed to guarantee consistent quality and stability of the vaccine components. Furthermore, both the safety for the target species and the risk for the user, the consumer, and the environment must be demonstrated. In addition, specific tests and studies are required to support the efficacy of the vaccine. The authorization procedures and related licensing requirements for avian vaccines to be marketed in the European Union (EU) based on the requirements of Regulation (EU) 2019/6 Article 8 and the Commission Delegated Regulation (EU) 2021/805 amending Annex II to Regulation (EU) No. 2019/6 are explained in the paper.